How do patient-reported and observed measures of shared decision-making compare in pancreatic cancer care? Insights from a cross-sectional study.

Objectives

Shared decision-making (SDM) is essential in pancreatic cancer care, where treatment decisions are complex and preference-sensitive. However, the relationship between patient experiences of SDM and observer-rated SDM remains unclear in the context of pancreatic cancer. This study aimed to examine the association between patient-reported and observer-rated SDM in the treatment decision for pancreatic cancer.

Methods

In this cross-sectional study at a tertiary hospital in the Netherlands, patients with non-metastatic pancreatic or periampullary cancer participated in audio-recorded surgical consultations. Patient-reported experiences of SDM were assessed using the SDM-Q-9 and CollaboRATE questionnaires, while observed SDM was rated using the OPTION-5 instrument by two trained researchers. All scores were standardized to a 0-100 scale. Correlations between measures were analysed using Spearman's rho.

Results

A total of 33 patients (median age 70 years; 36% male) were included in the final analysis. Median patient-reported experiences of SDM were high (SDM-Q-9: 88.9 [IQR 62.2-97.8]; CollaboRATE: 100 [IQR 88.9-100]), whereas the observed OPTION-5 score was lower (40 [IQR 32.5-55]). The association between SDM-Q-9 and OPTION-5 was negligible (ρ = 0.15), whereas the association between CollaboRATE and OPTION-5 was low (ρ = 0.34).

Conclusions

Patient-reported SDM was high, whereas observer-rated SDM scores were moderate. The limited associations between patient-reported and observer-rated SDM suggest that these measures capture different aspects of the decision-making process. PRACTICAL IMPLICATIONS Combining patient-reported and observer-rated measures may provide complementary information when evaluating SDM in pancreatic cancer care.